"These infants' respiratory limitations are generally due to immaturity of functional neural networks involved with swallowing and airway safety," Dr. Jadcherla says. "The treatment for managing them is patience and perseverance with the quality of oral feeding."
The researchers used manometry a pressure-sensitive tube inserted through the nose and into the esophagus to measure muscle contractions, swallowing, reflex strength and gastroesophageal reflux in all 20 participants. Infants with ALTE were slower to get back to normal aerodigestive regulation after an esophageal event (such as swallowing or gastroesophageal reflux), with a higher proportion of failed muscle contraction in the esophagus, more frequent episodes of pauses in breathing and more gasping breaths.
"For infants with esophageal function difficulties, proper positioning, proper feeding methods, taking time with the baby during oral feeding and allowing time for maturation to heal their problems are essential to protecting these babies from ALTEs," Dr. Jadcherla says. "We need to be patient in the care of such vulnerable little patients."
Understanding the causes of and treatments for near-death events in infants may also shed light on aerodigestive protective mechanisms implicated in some cases of sudden infant death syndrome, or SIDS.
"Gasping can be a mechanism for self-resuscitation when associated with swallowing, restoring respiratory normalcy," says Dr. Jadcherla, also a professor of pediatrics at The Ohio State University College of Medicine. "Although there can be many theories for death in any given infant with SIDS, the precise mechanisms or therapeutic targets in such infants when they are alive remain elusive. Understanding the aerodigestive mechanisms in the context of airway protection and feeding safety may offe
|Contact: Gina Bericchia|
Nationwide Children's Hospital